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Today’s article is about, “Quick Tip for Families in Intensive Care: ICU Wants to Move Dad with Tracheostomy & Brain Injury to LTAC Even Though He's Still Sleepy! Help!”

You may also watch this through this YouTube link https://youtu.be/AwEhfimG1pM or you can continue reading the article below.

Quick Tip for Families in Intensive Care: ICU Wants to Move Dad with Tracheostomy & Brain Injury to LTAC Even Though He's Still Sleepy! Help!

Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

So, we have a membership for families of critically ill patients in intensive care where you can become a member as well and we answer all questions, intensive care related in our membership for families of critically ill patients in intensive care. You can get access to our membership if you go to intensivecarehotline.com, if you’re clicking on the membership link or if you are going to intensivecaresupport.org directly.

Now, today, I want to answer a question from one of our members and I want to read out our member’s question and answer it so you can actually see what questions our members have and how we answer them. It’s really showcasing what you get in the membership. But also, for anyone that’s just curious about what we do at intensivecarehotline.com to give you a better sense.

So, I’m reading out the question from our member. “Hi, Patrik and team.” This is a member who had their dad in ICU for many months. So, here’s what she said,

“My dad has been off all antibiotics since Sunday, and they’ve done another blood draw that they’re doing a blood culture on to see if nothing comes up, I’m assuming. Right now, his white blood cell count looks good, and he still has slight fluid in his lungs. He’s been responding more with a Passy-Muir speaking valve and yesterday was the first day he had it in most of the day with maintaining blood oxygen levels on his own.

My concerns are he still seems very sleepy throughout the day and after therapy, which he only gets 1 hour a day, 3 days a week. He does respond to us with answering our questions but is it common that he doesn’t know how to speak well after having his tracheostomy or is it also his brain injury causing confusion? Could he still be slowly regaining consciousness as well? He isn’t completely out of his arm restraints, but they have suggested he go without them while my mom is with him.

He is scheduled to transfer sometime around the 20th of December and they’re suggesting a nursing home/LTAC (Long Term Acute Care) that has a short-term rehabilitation program. My concern is that it is a nursing home/LTAC though and I don’t want them to treat him like we want him there long-term.

I did find a place that’s an inpatient rehabilitation center only and it has a respiratory section that takes tracheostomy patients. I just wondered if he would have to qualify in other areas to be able to get into a facility like that one?

Thank you.”

“Well, thank you so much for sharing your dad’s current progress.

You mentioned that he has been off the antibiotics since Sunday and that they have done a follow-up blood culture to determine if the bacteria have been effectively cleared after the course of antibiotics. We hope that he remains free from any further infections.

It’s good to know that he’s been responding more and more with the Passy-Muir valve, and we hope that he’s been maintaining a good oxygen saturation of above 95%.

You mentioned that he’s sleepy throughout the day and after therapy and this may be due to a range of reasons: his medications, potentially inducing daytime drowsiness, the quality of his sleep during the night, or it might be related to the effects of his injury. Also, when someone has been in an induced coma for a prolonged period, there just seems to be delays in them waking up, unfortunately. The medications, therefore, could potentially inducing daytime drowsiness. As the quality of his sleep, if it persists, it would be helpful to review his latest blood test results, particularly like his ammonia levels and potentially also his carbon dioxide levels. His CO2 (carbon dioxide) levels could also make him sleepy. Additionally, checking blood gas results, could definitely provide insight. A follow-up with the neurologist is also important to reassess his neurological status and determine any necessary adjustments to his care plan.

It is not uncommon for someone who has undergone a tracheostomy and is recovering from a brain injury to experience difficulties in speaking and cognitive function. This is the reason why it is important that he is in regular sessions with physical therapy and occupational therapy, as well as speech therapy as these allied health therapies play a crucial role in supporting his recovery journey.

Regarding his arm restraints, it’s good that the medical team has suggested removing them, especially when your mom is present. This approach might aid his comfort, mobility, and overall recovery process. Otherwise, it is important to always check for any blood circulation issues in the area of restraints to prevent any potential negative effects.

Considering your dad’s complex medical situation, he meets the criteria, and he will benefit from the inpatient rehab center that specializes in handling patients with tracheostomy and recovering from brain injuries. It’s important that he will be transferred to a facility that aligns with his specific needs for his safety and recovery. You can request from the medical team that they consider transferring him there in his present state and per the family’s preference instead of an LTAC.

I really hope that helps.

If you have any other recent progress reports, you can send them to us so that we will have clinical insights based on the recent results of his blood works and any diagnostic exams done, doctor’s and nurse’s documentations, and determine his next course of care plan.

Please keep us updated and give us as much information as possible so we can guide you in the right direction.”

You will absolutely need to seek a facility that can look after his tracheostomy. But even better can they move towards taking out the tracheostomy here and then get him on to rehab. Your life will be so much easier. Then going home will also be a lot easier. So, I hope that helps.

He’s in the best place right now, even though he’s not making as much progress as he should, it’s much better than an LTAC or a skilled nursing facility. While I’m all for home care with Intensive Care at Home, he’s probably not quite there yet. But that is something you should also consider.  So, I hope that helps.

Now, if you want to become a member in our membership for families of critically ill patients in intensive care and you want your questions answered like we have done here, you can get access to our membership for families of critically ill patients in intensive care at intensivecarehotline.com by clicking on the membership link or you go to intensivecaresupport.org directly. Now, in the membership, you have access to me and my team, 24 hours a day, in the membership area and via email and we answer all questions, intensive care related.

I also offer one-on-one consulting and advocacy over the phone, Skype, Zoom, WhatsApp, whichever medium works best for you, and I answer your questions there. But I also talk to doctors and nurses directly so that you can make informed decisions, and have peace of mind, control, power, and influence.

I also represent you in family meetings with the intensive care teams so that you have clinical representation and advocate and that you don’t get walked all over because I know what questions to ask. I know how to manage intensive care teams.

I have worked in intensive care/critical care for over 20 years in three different countries where I also worked as a nurse unit manager in intensive care for over five years. I have also been advocating and consulting for families in intensive care at intensivecarehotline.com for the last 10 years. You can have a look at our testimonial and case study section for outcomes and results.

We also offer medical record reviews as part of our membership in real time so that you can get a second opinion in real time. We also offer medical record reviews after intensive care if you have unanswered questions, if you need closure, or if you are simply suspecting medical negligence.

Now, if you like my video, subscribe to my YouTube channel for regular updates for families in intensive care, click the like button, click the notification bell, comment below what you want to see next, what questions and insights you have from this video, and share the video with your friends and families.

Once again, thanks for watching.

This is Patrik Hutzel from intensivecarehotline.com, check out our website, and I will talk to you soon.

Take care for now.

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